SHELLI R CROCKETT (NPI# 1366548430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366548430 |
| Entity Type | Individual |
| Full Name | SHELLI R CROCKETT |
| Credential | NP |
| Practice Address |
96 15th St Nw 104 Norton VA 24273-1620 |
| Mailing Address |
172 Linden Dr Ste 100 Winchester VA 22601-2892 |
| Practice Telephone | 2766798890 |
| Practice Fax Number | 2766799740 |
| Mailing Telephone | 2766798890 |
| Mailing Fax Number | 2766799740 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2016-05-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024164715 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
96 15TH ST NW 104 |
| City | NORTON |
| State | VA |
| Zip Code | 24273-1620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083682983 | Jody B. Bentley | Internal Medicine | 96 15th St Nw, Suite 111, Norton, VA 24273-1625 | 2006-03-08 |
| 1750907143 | Mark Wantaja | Internal Medicine | 96 15th St Nw, Norton, VA 24273-1625 | 2020-06-22 |
| 1700371044 | Kenneth Wayne Smith IIi | Internal Medicine | 96 15th St Nw, Norton, VA 24273-1625 | 2018-06-28 |
| 1396156410 | Norton Community Physicians Services LLC | Orthopaedic Surgery | 96 15th St Nw, Suite 111, Norton, VA 24273-1620 | 2014-05-12 |
| 1972896256 | Norton Community Physician Services LLC | Internal Medicine | 96 15th St Nw, Norton, VA 24273-1620 | 2011-05-19 |
| 1861674160 | Norton Community Physician Services LLC | Nurse Practitioner | 96 15th St Nw, Suite 104, Norton, VA 24273 | 2007-11-29 |
| 1790986800 | Community Physicians Services Corporation | Clinic/Center | 96 15th St Nw, Suite 111, Norton, VA 24273-1620 | 2007-05-29 |
| 1063631927 | Edward B Boyd | Registered Nurse | 96 15th St Nw, Suite 104, Norton, VA 24273-1620 | 2007-04-25 |
| 1942306006 | Phyllis Brummitte | Nurse Practitioner | 96 15th St Nw, 104, Norton, VA 24273-1620 | 2006-09-16 |
| 1275637241 | Norton Community Physicians Services | Pharmacy | 96 15th St Nw, Ste 101, Norton, VA 24273-1620 | 2006-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457978751 | Donald Arthur Olson | Family Medicine | 1900 Holten Ave E, Big Stone Gap, VA 24273 | 2020-07-02 |
| 1528696440 | Kristi Matthews | Occupational Therapist | 22 10th St Nw, Norton, VA 24273 | 2020-03-27 |
| 1851929772 | Julie Ann Hoffer Mullins | Physical Therapist | 22 10th Street N.w., Norton, VA 24273 | 2020-03-27 |
| 1053839977 | Vijay Kumar PC | Family Medicine | 610 Park Avenue Nw, Norton, VA 24273 | 2017-08-30 |
| 1407376312 | Jacob A Nysather | Internal Medicine | 100 15th Street, N.w., Norton, VA 24273 | 2017-06-21 |
| 1154854248 | Family Preservation Services, Inc | Community/Behavioral Health | 5338 Esserville Road, Norton, VA 24273 | 2017-04-06 |
| 1245771757 | Blue Ridge Medical Management Corporation | Internal Medicine | 1410 Park Ave Nw, Norton, VA 24273 | 2017-03-16 |
| 1821548413 | William Luke Alls | Internal Medicine | 96 15th St., Suite 106, Norton, VA 24273 | 2016-10-07 |
| 1073978383 | Stephen Souther | Counselor | 515 Park Avenue Sw, Norton, VA 24273 | 2015-12-31 |
| 1306251889 | Rafaqat Rashid | Internal Medicine | 100 15th Street N.w, Norton Community Hospital, Internal Medicine Residency, Norton, VA 24273 | 2014-06-24 |
| Find all providers in zip 24273 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255967261 | Amanda Christine Croasmun | Nurse Practitioner | 3631 Durham Dr, Norton, OH 44203-6338 | 2020-03-21 |
| 1780182253 | Victoria Whitt | Nurse Practitioner | 692 Hamner Ave Ne, Norton, VA 24273-1124 | 2018-01-30 |
| 1275179129 | Lora Lou Karg | Nurse Practitioner | 1193 Norton Ave Ste A, Norton, OH 44203-9526 | 2019-11-25 |
| 1851937932 | Theresa Franey | Nurse Practitioner | 35 W Main St, Norton, MA 02766-2711 | 2019-11-22 |
| 1801359450 | Heather Childress | Nurse Practitioner | 610 Park Ave Nw, Norton, VA 24273-1922 | 2019-04-10 |
| 1134630098 | Ulema Graham | Nurse Practitioner | 184 W Main St, Norton, MA 02766-1243 | 2017-10-18 |
| 1578093662 | Megan Leann Nicely | Nurse Practitioner | 100 15th St Nw, Norton, VA 24273-1616 | 2017-06-13 |
| 1992237317 | Stephanie Williams | Nurse Practitioner | 102 15th St Nw, Suite 301, Norton, VA 24273-1627 | 2017-04-03 |
| 1437698321 | Sidney Ballard | Nurse Practitioner | 1761 Park Ave Sw, Norton, VA 24273 | 2017-02-13 |
| 1023484797 | Rachel Lauren Cox | Nurse Practitioner | 184 W Main St, Norton, MA 02766-1243 | 2015-08-18 |
| Find all providers in NORTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.